加味三拗汤治疗上气道咳嗽综合征风痰型临床研究

Clinical Study on Modified San’ao Tang for Upper Airway Cough Syndrome of Wind-Phlegm Type

目的:观察加味三拗汤治疗上气道咳嗽综合征(UACS)风痰型的临床疗效及对外周血Th1/Th2细胞因子水平的影响。方法:选取92例风痰型UACS患者,按随机数字表法分为治疗组及对照组各46例,试验结束共有3例患者脱落,最终对照组45例,治疗组44例。治疗组予以加味三拗汤治疗,对照组予以氯雷他定片联合孟鲁司特钠片治疗,2组疗程均为2周。观察2组治疗前后中医证候评分、生活质量[莱塞斯特咳嗽生命质量问卷(LCQ)]评分、外周静脉血[γ-干扰素(IFN-γ)、白细胞介素-4 (IL-4)]变化,比较2组治疗后不良反应发生率,观察2组临床疗效。结果:治疗后,2组咳嗽、咳痰、咽痒、鼻后滴漏、咽部体征评分均较治疗前降低(P<0.05),治疗组咳嗽、咳痰、咽部体征评分均低于对照组,差异均有统计学意义(P<0.05)。治疗组临床疗效总有效率为90.91%,对照组总有效率为77.78%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组LCQ评分均较治疗前上升,治疗组高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组外周血IFN-γ水平均较治疗前上升(P<0.05),IL-4水平均较治疗前下降(P<0.05);治疗后,治疗组IFN-γ水平高于对照组,IL-4水平低于对照组,差异均有统计学意义(P<0.05)。在治疗过程中及治疗后,2组生命体征平稳,血、尿常规及肝肾功能指标均未见明显异常。治疗组不良反应发生率为0,对照组17.78%,2组比较,差异有统计学意义(P<0.05)。结论:加味三拗汤治疗风痰型UACS疗效显著,能调节细胞因子水平,提高生活质量,用药安全性较高。

Objective:To observe the clinical effect of modified San’ao tang for upper airway cough syndrome(UACS) of wind-phlegm type and its effect on levels of Th1/Th2 cytokines in peripheral blood. Methods:A total of 92 cases of UACS patients of wind-phlegm type were selected and divided into the treatment group and the control group according to the random number table method,with 46 cases in each group. After experiment,three cases of patients were lost,and finally with 45 cases in the control group and 44 in the treatment group. The treatment group was treated with modified San’ao tang,and the control group was treated with loratadine tablets and montelukast sodium tablets. Both groups were treated for two weeks. Before and after treatment, the changes in Chinese medicine syndrome scores, quality of life of Leicester Cough Questionnaire(LCQ) scores,and peripheral vein blood including interferon-γ(IFN-γ) and interleukin-4(IL-4) in the two groups were observed. After treatment, the incidences of adverse reactions and clinical effects in the two groups were compared. Results: After treatment, the scores of cough, expectoration, throat itching, postnasal drip and pharyngeal signs in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of cough,expectoration and pharyngeal signs in the treatment group were lower than those in the control group, differences being significant(P<0.05). The total effective rate of clinical effect was 90.91% in the treatment group and 77.78% in the control group,the difference being significant(P<0.05). After treatment,the LCQ scores in the two groups were increased when compared with those before treatment, and the score in the treatment group was higher than that in the control group,differences being significant(P<0.05). After treatment, the levels of IFN-γ in peripheral blood in the two groups were increased when compared with those before treatment(P<0.05),and the IL-4 levels were decreased(P<0.05);the IFN-γlevel in the treatment group was higher than that in the control group, and the IL-4 level was lower, differences being significant(P<0.05). During treatment and after treatment,there were stable vital signs in the the groups and no abnormality in blood routine,urine routine and liver and kidney function. The incidence of adverse reactions was 0 in the treatment group and 17.78% in the control group,the difference being significant(P<0.05). Conclusion:Modified San’ao tang for UACS of wind-phlegm type has a significant curative effect and can regulate levels of cytokines and improve quality of life,with higher medication safety.